While acupuncture has been introduced to a number of health systems throughout the world, its use in the (ED) is rare. This study evaluated the efficacy and safety of acupuncture compared with that of morphine for adults presenting to the ED with acute pain.

This prospective, randomized, non-blinded trial included adult patients presenting to the ED of a university hospital in Tunisia with acute pain syndromes. All patients reported a pain intensity of at least 40 on a 100-point visual analogue scale (VAS). In the group randomized to receive acupuncture (n＝150), protocols were selected from a pool of predetermined acupuncture points for each condition. Those randomized to the morphine group (n＝150) received IV morphine, titrated from an initial dose of 0.1 mg per kilogram, adding a dose of 0.05 mg per kilogram every five minutes, until reaching sufficient pain relief, to a maximum of 15 mg. The primary outcome measure was pain severity at baseline and five, 10, 20, 30, 45, and 60 minutes.

Success, defined as a reduction of at least 50% in pain severity from baseline, was achieved in 92% of the acupuncture group and 78% of the morphine group (P<0.01). Pain resolution time averaged 16 minutes in the acupuncture group and 28 minutes in the morphine group (P<0.01). Minor adverse events were experienced by 56.6% of those in the morphine group and 2.6% in the acupuncture group.

This randomized trial of patients presenting with acute pain in the emergency department found that acupuncture could provide better and quicker relief than could IV morphine.